title: Use of insecticide treated nets by pregnant women and associated factors in a pre-dominantly rural population in northern Ethiopia.
abstract: OBJECTIVE
  To describe the use of insecticide treated nets (ITNs) among pregnant women and examine factors associated with its access and use.
  
  
  METHODS
  Community-based cross-sectional study of 815 pregnant women in eight malarious kebeles in northern Ethiopia based on two-stage cluster design from May to June 2006. Knowledge on malaria, its cause and preventive measures; treatment seeking behaviour; possession and use of ITNs by pregnant women and under-five children were ascertained through interview and observation. Logistic regression was used to determine factors associated with ITNs use.
  
  
  RESULTS
  Knowledge about the cause, transmission and preventive measures of malaria was relatively good; 90.2% of women associated malaria with mosquito bites and 94.2% with living near water ponds. Ten per cent reported malaria illness within the 14 days before the survey, and sought treatment mainly from public health facilities (56.5%) and community health workers (37.6%). Of 815 households surveyed, 59% owned at least one non-long lasting or long-lasting ITN (59.5% rural vs. 54.5% urban; P = 0.401). Lack of access to ITNs (68.3%) and the perception that nets could not prevent malaria (27%) were the main reasons for non-ownership of nets. A total of 58.4% of 481 pregnant women from households owning at least one ITN had slept under it during the previous night. Fewer rural (56.7%) than urban women (76.2%) used ITNs (P = 0.001). In 57.6% of households with at least one ITN, under-five children had used it the night before. Higher educational attainment was an important predictor of ITNs use (OR = 3.1, 95% CI = 2.1, 4.6).
  
  
  CONCLUSIONS
  Household ownership of ITNs and their use by pregnant women is promising with the current efforts to scale-up ITNs implementation, but the gap between ownership and use remains high. Consistent and proper use of nets by pregnant women should be ensured through information campaigns. Rapid expansion of access to long lasting ITNs requires that government and NGOs supply them in adequate numbers.
authors.affiliation: UNICEF Country Office, Addis Ababa, Ethiopia.
authors.forename: Mebrahtom
authors.initials: M
authors.lastname: Belay
authors.forename: Wakgari
authors.initials: W
authors.lastname: Deressa
mesh_terms: D000328:Adult; D001512:Bedding and Linens / Q000191:economics / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007306:Insecticides / Q000191:economics; D007407:Interviews as Topic; D008288:Malaria / Q000517:prevention & control* / Q000635:transmission; D008297:Male; D009032:Mosquito Control / Q000191:economics / Q000379:methods*; D010342:Patient Acceptance of Health Care; D011203:Poverty; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods; D012423:Rural Health / Q000592:standards
chemical_list: D007306:Insecticides